This application for a Research Training Grant (T32) is designed to train and mentor clinician scientists from the disciplines of neurology and emergency medicine who will become collaborative leaders in the investigation of the causes and treatment of cerebrovascular disease. We are requesting support for two fellows per year for the first year and four fellowship positions for years 2-5. The mentored two-year program includes course work and extensive hands-on experience in clinical research, close interactions with basic scientists, and unique training in the evaluation and treatment of patients with acute stroke. Our training program is comprised of an extensive network of collaborators and mentors that has resulted in academic productivity among our graduates. Each trainee has a mentoring team of three individuals and chooses a specific research project within the first three to four months of training. Current faculty for this training grant and their focus areas include: Joseph Broderick MD (Director of Training Program - stroke epidemiology, clinical trials, and genetics of stroke), Arthur Pancioli MD (Co-Director of Training Program - clinical trials), Joseph Clark PhD (Director of basic science experience - in vitro and vivo stroke models, cerebrovascular physiology), Daniel Woo MD (Director of neurosonology, genetics of stroke), Thomas Tomsick MD (endovascular therapy, neuroradiology, clinical trials), Brett Kissela MD (stroke epidemiology, stroke outcomes), Edward Jauch MD (proteomics of stroke, clinical trials), Ranjan Deka (molecular and population genetics), Alex Schneider (clinical trials), Dawn Kleindorfer (clinical trials), Christy Holland PhD and George Shaw MD, PhD (cerebrovascular ultrasound), Joel Tsevat (outcomes and quality of life), Kenneth Wagner, PhD (animals models of hemorrhagic and ischemic stroke), Steve Page, PhD (stroke recovery), Scott Holland PhD and Steve Strakowski MD (neuro imaging), Mario Zuccarello MD and Raj Narayan MD (cerebrovascular surgery and thrombolytic stroke), Ronnie Horner PhD (healthcare epidemiologist and outcomes), Rakesh Shukla PhD (biostatistics), and Michael Lehman PhD (circadian rhythms and stroke, Neuroscience Graduate Program). Potential trainees must have completed a residency in neurology or emergency medicine and must demonstrate a commitment to an academic career in cerebrovascular disease.